Exserohilum species
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Exserohilum /
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Clinical Manifestations
- Opportunistic pathogen in the immunocompromised, including aplastic anemia and HSCT
- Causes keratitis, sinusitis, cutaneous, and subcutaneous infections
- Of note, in 2012, it caused an outbreak of fungal meningitis associated with contaminated steroid injections (source was the compounding pharmacy)
Diagnosis
- Culture
- Colony: Growth is rapid and colonies are woolly and gray to black in color
- Microscopy
- Hyphae are septate and dematiaceous
- Conidiophores are geniculate as a result of sympodial development
- Conidia may be straight, curved or slightly bent and are distinguished by having prominent, protruding hila
Management
- Amphotericin B, itraconazole, voriconazole, and posaconazole have all been used successfully1
- An expert group has recommended voriconazole for CNS disease based on very little data
References
- ^ A. Katragkou, Z.-D. Pana, D. S. Perlin, D. P. Kontoyiannis, T. J. Walsh, E. Roilides. Exserohilum infections: Review of 48 cases before the 2012 United States outbreak. Medical Mycology. 2014;52(4):376-386. doi:10.1093/mmy/myt030.
